Last updated on 09/25/2020
Layton, Tim, Nicole Maestas, Daniel Prinz, Mark Shepard, and Boris Vabson. In Preparation. “Grading Medicaid: Fiscal Federalism and Social Insurance in the United States”.
Abstract:In this paper, we seek to unpack the variation in Medicaid spending across states using a novel empirical strategy. We leverage data describing demographics, fiscal spending, and mortality for the universe of Medicaid enrollees linked to similar data for the universe of Medicare enrollees. We use this data to allow us to compare fiscal spending and health effects of each state’s Medicaid program relative to a single, homogeneous alternative program: Medicare. By comparing each state’s Medicaid program to Medicare, we can effectively compare each state’s Medicaid program to each other state’s Medicaid program, allowing us to assess the extent to which program factors influence the variation in observed Medicaid spending across states.